AC-LON-2025-000755 - [2025] EWHC 2014 (Admin)

I accept the Claimant’s letter of 7 October 2024 requested that the assessment “…include specialist input from a psychologist, from a learning disability specialist and an autism specialist”. I do not accept that “the Defendant was required either to adhere to the request or provide adequate reasons for declining to do so.” At its highest, the 7 October 2024 letter might be taken as an expression of the Claimant’s “wishes and preferences”. If that is right, the Defendant needed only to “have regard” to them when carrying out the assessment.

The question of who needs to be involved in the assessment remains a matter for the judgment of the Defendant generally, and in particular for the professional judgment of the assessors. The obligation to involve others arises “where it considers that the needs of the individual concerned require it to do so.” Even in cases of “particularly complex or multiple needs,” the Defendant must still consider if the input of other is “required.” In my judgment the evidence falls far short of allowing me to conclude that the assessment was unlawful because the input of others was “required.”

Insofar as the challenge amounts to a rationality challenge (as the Defendant characterised it) it cannot in my judgment be said that the decisions “do not add up” so that they reveal in each case an error of reasoning which robs them of logic. Social workers are highly trained, have responsibilities to keep their training up to date as a condition of continued registration and, in the present case, have a good deal of experience. The context of the assessment was that the Claimant was well known to HDLP, to the Defendant and to other bodies outside the Defendant. Taking these factors into account, I am satisfied that the decision to proceed without further input was not irrational.

There is no suggestion (and certainly no evidence) that the Defendant has failed to implement the national adult autism strategy or that it had failed to provide (as it must) “general autism awareness to all frontline staff” and “specialist training for those conducting needs assessments.” Patience Boafo’s evidence confirms that she has received appropriate training and has experience of carrying out needs assessments for those with autism. The assertions that she lacked the “skills, knowledge and competence” to conduct the assessment and that other expertise was required, appears to be based on an assumption that anyone with the Claimant’s presentation would need specialist input. I do not accept that. It is clear from the guidance that the approach is always fact specific.

As to capacity, the assessors proceeded on the basis that the Claimant lacked capacity in respect of the formation and maintenance of healthy sexual relationships. There was no suggestion at all that the Claimant lacked capacity in any other area (and linked to that, social media use in respect of which I have seen a capacity assessment dated 20 May 2020). None of the medical professionals who have assessed him have expressed any concern about capacity and each appears to have been confident that the Claimant was well supported to make relevant decisions.

Nothing in the assessment I am concerned with appears to have triggered any concern about capacity. The report notes that the Claimant sat between Natalie, one of his carers and his mother (referred to as DDB) and “asked them to advocate on his behalf.” It is clear from the assessment that they performed that task with care. No one at the meeting raised any concerns and there are some indications that the Claimant engaged appropriately. He is entitled to the important presumption of capacity. I have seen nothing to suggest that there was any cause for concern about the Claimant’s capacity to make a specific decision after appropriate support has been offered. The Defendant was therefore in my judgment entitled to proceed without a capacity assessment.

Ground 2 is a pure irrationality challenge. I will deal with the impugned decisions in this order: the conclusion in respect of “physical support needs;” the conclusion of the extent of the Claimant’s learning issues and the conclusion in respect of the Claimant’s ability to access mainstream health care.

In my judgment it is plain, reading the assessment as a whole, that the reference to the Claimant having “physical support needs” is not a conclusion at all. Reading the report as a whole, the reasons for the Claimant’s need for care are plain. They are not related to physical issues. The reference to physical support needs is wholly irrelevant to the outcome of the report.

It is also plain in my judgment that the Defendant did not reach its own decision on the extent of the Claimant’s learning issues. The assessors relied on the professional views of others who were qualified to express the view. In submissions, it was suggested that the Defendant at least “endorsed” the decision that the Claimant had a learning difficulty. I do not accept that submission. I am satisfied that the Defendant (through the assessors) simply took the opinion of those qualified to give it and applied it. It was plainly not irrational for the assessors to do so. It was suggested that the Defendant should have required that the Claimant undertake further examination or consideration. I reject that submission. I accept it would have been possible for the Defendant to ask for a re-assessment, but it is far from clear why they would have done so.

Finally, I deal with access to healthcare services. The Claimant prayed in aid of this submission, the fact that the Claimant had in fact not been able to access any health services since the assessment. Whilst that (as a fact) is of concern, it is not material to the question before me. The lawfulness of the decision must be assessed at the time it was made, and in light of the facts and matters known to the decision maker at the time. In any event, on a proper reading, the report proceeded on the basis that the Claimant would require support to access mainstream services. It was not suggested that he could do so without help and assistance. This approach is consistent with the conclusions expressed by Dr Kikoler in 2019, the Black Country NHS Trust in its letter of 23 August 2021 and the Defendant’s letter of 10 June 2024. There is a broad measure of agreement between the experts that the Claimant was able to function at a level higher than that to be expected of someone with a learning disability. The decision that the Claimant could access mainstream services with help was plainly not irrational.

The first, and broader aspect of ground 3 must in my judgment fail for a number of reasons. First, the Defendant was not applying the policy when it conducted the assessment. It did not make the decision to exclude the Claimant from HLDP, that decision had already been taken in May 2024. Secondly, it is clear that the Defendant’s approach took a flexible approach to the policy. That flexibility is plain from all of the reports I have seen which address eligibility (even those from the Black Country, which are not examples of the Defendant’s flexibility, but are examples of a common approach). The Defendant’s flexible approach is best shown by the June 2024 letter from Dr Tomlinson. She made it clear that the real question was where could the Claimant’s needs best be met, not whether he had a particular diagnosis.

The second limb of ground 3 was raised for the first time at the hearing. There was no objection from the Defendant, and I am prepared to deal with the argument. However, this approach should not be seen by the Claimant as a slackening of the need for procedural rigour (including not raising arguments which are not clearly foreshadowed).

The problem with the second part of ground 3 is that, on the findings I have made, there was no sensible basis on which the Defendant could have been expected to consider a referral back to HLDP for a fresh assessment.

For all of these reasons, the claim is dismissed.

In conclusion, no matter what the precise extent of the Claimant’s learning issues is, he has been shown to function at a higher level than those with learning disabilities. That being the case it seems clear that it is in his best interests to receive mainstream, rather than specialist, care. He has shown himself able to achieve a great deal if he has the appropriate support. That is in my judgment a matter for celebration.

I am grateful to counsel for their helpful and focussed submissions.